O Brazil to live an even more challenging situation from the point of view of public health as of the next few weeks: the country will carry out two mass campaigns of vaccination simultaneously.
According to the Ministry of Health, on April 12 the immunization against gripe, which happens every year from the beginning of autumn, when the temperature starts to fall and the circulation of vrus that affect the respiratory system (as in the case of influenza, the cause of the disease) increase considerably.
Campaigns against influenza and covid-19 will happen in parallel and already raise doubts about who should take the doses, what is the waiting time between a vaccine and another and how to be organized to avoid agglomerations in health posts.
BBC News Brasil consulted experts to answer the main doubts and understand the importance of protecting themselves against these two diseases.
Who can get vaccines against covid-19 and flu?
It is necessary to pay close attention, as the priority groups and the order in which they will be served change a little according to each campaign.For now, Brazilian municipalities are vaccinating health professionals and people over 60 in different age groups against the covid-19. Many places started by calling individuals over 90 years old and gradually reduced their age.
The expectation is that education workers and the security and rescue forces will start taking their doses against the coronavirus in the next few weeks, according to the schedule of each city hall.
In the case of influenza vaccination, the first recipients will be:
- From 04/12: children, pregnant women, mothers (women who recently had children), indigenous people and health workers;
- As of 05/11: people over 60 and teachers;
- Between 9/06 and 9/07: individuals with permanent comorbidities or disabilities, truck drivers, road and port system workers, security forces and the Armed Forces, prison system employees, the deprived population of freedom and young people from 12 to 21 years of age who are under socio-educational measures.
Generally, flu campaigns start with the elderly. But, in 2021, they were transferred to a second stage to avoid confusion and conflict with the timetable established against the covid-19.
The expectation is that, as of May, the majority of individuals over the age of 60 will be properly protected against the coronavirus and will be free to also protect themselves against influenza.
“To avoid risks, managers will need to organize themselves optimally with different lines, times and spaces, so that there is no overcrowding of people in health units”, suggests epidemiologist Jose Cassio de Moraes, full professor at Faculdade de Cincias Mdicas da Santa Casa de So Paulo.
Which vaccine should be prioritized?
Both immunizers are essential and help to prevent respiratory complications that require hospitalization and can even lead to death.
If you are part of the target audience of the two campaigns at some point in the coming months, priority should be given to vaccine against covid-19.
“This is the recommendation of the National Immunization Program (PNI) of the Ministry of Health and it has to do with the fact that we are in the middle of a pandemic”, explains doctor Maria de Lourdes de Sousa Maia, coordinator of the Clinical Advisory of Bio-Manguinhos , from Fundao Oswaldo Cruz (FioCruz).
But the priority should not be confused with exclusivity: it is important to be vaccinated against the flu in the sequence, respecting the deadline guided by the specialists, as you will see below.
Can I get the vaccines against covid-19 and flu together on the same day?
There is no need to wait 15 days between one vaccine and another, according to the guidelines of the public health authorities.
But what is the reason for this two-week break?
“We do not yet have co-administration studies, which would allow us to know the response of the immune system to the joint application of the two immunizers, against flu and against covid-19”, explains the doctor Patricia Mouta, a pharmacovigilance professional from Bio-Manguinhos / FioCruz.
As research on the topic has not yet been carried out, the Ministry of Health opted for prudence, to avoid any unexpected side effects or a decrease in the effectiveness of immunizers.
Let’s see examples of how this scheme will work in practice: you can take the first dose of Coronavac and wait 14 to 28 days to receive the second dose of this same vaccine.
You need to wait two more weeks to be vaccinated against the flu (which requires only one dose to provide protection).
In the case of the AZD1222 immunizer, from AstraZeneca and Oxford University, the order of vaccination changes, since the period between the first and the second dose is three months.
You can then take your first dose of AZD1222 and wait two weeks to receive the flu shot.
Then, just wait the remaining two and a half months to complete protection against covid-19 with the second dose of AZD1222.
What is the importance of getting vaccinated against these two diseases?
Both flu and covid-19 are diseases that affect the respiratory system, can cause complications or sequelae and even kill.
From an individual point of view, therefore, vaccination decreases health risks.
From a collective perspective, an attitude that protects the entire community is immunized, as it breaks the chains of viral transmission and prevents the influx of hospitals and intensive care units.
In other words, when you take your doses, you not only protect yourself, but also your family, friends, neighbors and everyone around you – even those who, for one reason or another, cannot get the vaccine.
Does Brazil have guaranteed doses to protect the population against covid-19 and the flu?
The situation varies widely. In the case of influenza vaccines, the concern about a possible shortage, almost nonexistent.
This is because Brazil is self-sufficient in this regard: the manufacture is under the responsibility of the Butantan Institute, which does not even depend on the import of the active pharmaceutical ingredient (IFA) to deliver 80 million doses to the Ministry of Health every year.
Butantan has the largest factory of influenza immunizers in the entire Southern Hemisphere.
When the subject covid-19, the subject complicates a little.
Our country depends on IFA shipments from China and India to finalize the filling of doses of Coronavac, at the Butantan Institute, and AZD-1222, at FioCruz
Due to the worldwide demand for the product, since January 2021 deliveries have suffered delays and unforeseen events, which have even paralyzed the vaccination campaigns against coronaviruses in some cities.
“To speed up people’s immunization, we need to have more doses of vaccines available,” points out epidemiologist Carla Domingues, who was coordinator of the PNI between 2011 and 2019.
In the past few days, both Butantan and FioCruz have managed to expand the delivery of new batches of vaccines against covid-19, which promises to give more predictability to state and municipal governments.
In addition, other vaccines that already have a purchase agreement with the Ministry of Health should arrive from the coming months, such as those produced by Pfizer and Johnson & Johnson.
The ministry’s provisional calculation is that Brazil would already have more than 500 million guaranteed doses for 2021.
What are the challenges of running two campaigns simultaneously?
In addition to the issues of organization and logistics, the experts heard by BBC News Brasil call attention to the challenge of making good communication to people about simultaneous campaigns.
And, in their evaluation, Brazil is doing poorly in this regard.
“I cannot say that the communication is bad because it would mean that there is something being done. The communication is absent. There is no official advertisement or campaign,” criticizes Moraes.
For now, the Federal Government has run few advertisements or other content in physical and digital media to talk about target audiences, when people should be vaccinated or what documents are needed.
“What we have seen are only advertisements about vaccine purchases. It is necessary to explain to the population about the need to take the two doses, respect the intervals, among other things. This communication is not being made,” notes Domingues.
BBC News Brasil contacted the press office of the Ministry of Health to hear their version on this point, but even the publication of this report did not get a response.
Maia, who was coordinator of the PNI between 1995 and 2005, points out that, however much experience Brazil has in immunizations, it needs to adapt to a new reality.
“Do vaccination campaigns to reinvent yourself all the time. Staying the same recipe for failure”, thinks the doctor.
“We need to understand the moment we live in and estimate the impact that fake news and WhatsApp currents can have on accepting vaccines. We will have to deal with and overcome this,” he adds.
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Or what or coronavrus
Coronaviruses are a large family of viruses that cause respiratory infections. The new coronavirus agent (COVID-19) was discovered in December 2019 in China. The disease can cause infections with symptoms initially similar to colds or flu, but with the risk of getting worse, which can result in death.
The transmission of coronaviruses usually occurs by air or by personal contact with contaminated secretions, such as saliva droplets, sneezing, coughing, phlegm, close personal contact, such as touching or shaking hands, contact with contaminated objects or surfaces, followed by contact with mouth, nose or eyes.
The recommendation is to avoid crowding, stay away from those with symptoms of respiratory infection, wash your hands frequently, cough with your forearm in front of your mouth and often use soap and water to wash your hands or gel alcohol after contact with surfaces and people. At home, take extra precautions against COVID-19.
Main symptoms of people infected with COVID-19:
- Shortness of breath and difficulty breathing
- Gastric problems
- In severe cases, victims have:
- Severe acute respiratory syndrome
- Kidney failure
- The types of symptoms for COVID-19 increase every week as researchers move forward in identifying virus behavior
Myths and truths about the virus
On social media, the spread of COVID-19 also spread rumors about how the Sars-CoV-2 virus is transmitted. And other doubts arose: Is alcohol gel capable of killing the virus? Is the coronavirus lethal at a worrying level? Can an infected person infect several others? Will the epidemic kill thousands of Brazilians, since SUS would not be able to serve everyone? We did a report with a doctor specializing in infectology and he explains all the myths and truths about the coronavirus.
To learn more about the coronavirus, read also:
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